Provider Demographics
NPI:1407546757
Name:WHITFIELD, ANNIEKIA MARINA (LPN)
Entity Type:Individual
Prefix:MS
First Name:ANNIEKIA
Middle Name:MARINA
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 CHOATE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-1925
Mailing Address - Country:US
Mailing Address - Phone:716-465-3591
Mailing Address - Fax:
Practice Address - Street 1:74 CHOATE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-1925
Practice Address - Country:US
Practice Address - Phone:716-465-3591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY341231164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse